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. 2025 Sep 5.
doi: 10.1159/000548277. Online ahead of print.

Uveal Melanomas Masquerading as Inflammatory Lesions

Malcolm Wiseman Jr  1 , Timothy Fuller  2 , R Nick Hogan  3   4 , J William Harbour  3   5 , Noy Ashkenazy  3
Affiliations

Uveal Melanomas Masquerading as Inflammatory Lesions

Malcolm Wiseman Jr et al. Ocul Oncol Pathol. .

Abstract

Introduction: Most uveal melanomas (UMs) are readily diagnosed based on their characteristic features, but they can occasionally pose a diagnostic challenge, such as when they present as an inflammatory mass. We present 2 patients who presented with an intraocular mass that was initially diagnosed as an inflammatory or infectious process and subsequently found to represent a UM.

Case presentations: Two cases of UM masquerading as uveitis are described.

Conclusion: UM should be considered in the differential diagnosis of an intraocular inflammatory mass. Diagnosis may require tumor biopsy.

Keywords: Case report; Inflammation; Melanoma; PRAME; Uvea; Uveitis.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: none (M.W., N.A., T.F., and R.N.H.); Castle Biosciences (J.W.H.).

Figures

Fig. 1.
Fig. 1.
a Image of hypopyon found on initial exam. b Image of B scans of the posterior segment mass OS from the initial exam. c Fundus photography showing clearing opacities in the posterior segment. d B scan showing growth off posterior segment mass 6 weeks later. e Cytopathology thin prep showing two, Papanicolaou stained, pigmented cells with large nuclei, and prominent nucleoli.
Fig. 2.
Fig. 2.
a Longitudinal view on ultrasound biomicroscopy of UM. Iris lesion extending to ciliary body and choroid inferiorly. b Axial view on ultrasound biomicroscopy showing iris lesion extending in inferior angle. c Gonioscopy showing dense pigment depositions in the inferior angle. d Image of B scans showing a lobulated mass with heterogeneous echogenicity and acoustic hollowing. e Cytopathology showing H&E-stained melanoma cells. f Cytopathology showing positivity for HMB-45 immunohistochemical stain.
See this image and copyright information in PMC

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